Merinda Epstein - A Consumer Activist's Guide
To Mental Health In Australia
Mental Health and Work
Paper for Western Australian Association for Mental Health WAAMH
"....I like to describe us in a positive way by indicating that we are the exquisitely sensitive ones. If you listen to us you may learn something about the corporate air- about the emotional health of the organisation. People with exquisite sensitivity have something to offer. Society at work might just learn something from us and we might, at last, start to be seen as an asset in the workplace culture - an important litmus test of occupational sanity."
I've been invited here to talk about mental health and work.
However, before doing this I would like to talk briefly about language. There are a variety of ways that people who have experienced emotional distress and sort professional help are described. Most of these ways are the preferred language of the professionals rather than the language chosen by the people themselves. In this paper I will use the word ‘consumer’ to describe myself and others who have been labelled as having a mental illness or who seek services to try and ameliorate our mental health. The use of a term has not gone without challenge. It is criticised by many professionals who are uncomfortable with a new language that appears alienating and reductive. It is also criticised by many consumers particularly as it implies our relationship with service providers is centrally located in the market place. Sometimes the preferred term is ‘client’ or ‘patient’ but I don’t use these words much because the medical profession owns one and the other has been colonised (within health) by allied health practitioners. Overseas consumers have chosen a variety of ways of naming themselves; survivors is used in northern America and in Britain and New Zealand the term ‘user’ is often used. Pinches1 argues that the word ‘consumer’ is far from perfect but that it is the best one we have available to us at the present time. Wadsworth adds that we’ll know when it needs to be replaced by new language when professionals start to say “my consumer” in the way they comfortably say, “my client” or “my patient”.
Whilst I am briefly mentioning language I would like to point out something else that is happening within the consumer movement in Australia. Some of us are starting to reclaim old derogatory language in the same way that comedians revamped ‘wogs’ and the gay and lesbian movement started to reclaim ‘poofter’ and ‘dyke’ and play with them. Some of us are now starting to describe ourselves as ‘mad’, ‘loonies’ ‘lemons’, and ‘nutcases’. At one end of the political landscape there is a vanguard flaunting our mad pride whilst at the other end some people are still trying to get treated respectfully and the derogatory slurs off their back. Humour is an important part of recovery. It is also an important aspect of political efficacy. Sometimes, others, remain aghast at our determination to own our own lives (and our own language).
Hands up those people in the room who know about Myers-Briggs. Sorry! I can already see the rolling eyes and other cynical reactions. Humour me and listen for a short while. I’m going to, quite deliberately, use a different set of labels than the one we are perhaps more used to in mental health circles – those which pathologise us.
However, in order to make this discussion sensible for those who have not heard of Myers-Briggs I will briefly outline what it is. It is not necessary to know the detail about these particular typologies.
Myers and Briggs were two women – mother and daughter. They were Jungian psychologists. Early in the 20th Century they developed a theoretical structure to help us understand difference between the way different groups of people thought, prioritised and preferred to work.
The theory they developed was to become known as Myers-Briggs. Interestingly their first book was titled, “Gifts Differing”. How different from the dominant medical models of categorisation which assign us to groups on the basis of what is wrong about us. Here the categories are in terms of the gifts we bring to society and to the workplace.
For the purpose of this short talk I would just like to outline in very broad terms the axes on which their understandings are located. Their work is a great deal more sophisticated than what I am able to present.
Myers Briggs has four sets of opposite characteristics represented by letter indicators. On the first rung there is an axes which has extravert (E) on one side balanced by introvert (I) on the other. This is not just about whether some one is presumed to be loud or quiet. It is much more about where we, as individuals, get our energy drive and balance. Do we prefer to go out into the community and gather strength and energy from interaction or do we prefer to go into ourselves for energy. The second pair of attributes is sensate (s) and intuitive (n). Are we as people (and as workers) interested in facts, details and accuracy or are we most interested in theory building, creating big pictures and understanding how things fit together. The third set is thinking (T) or feeling (F). That is, are we driven to do the things we do because it is ‘right’, ‘ethical’ and because we are driven by our values or are we driven to do the things we do because it ‘makes logical sense’, ‘gets things done’ ? And finally the fourth axes is the delineation between judgers and perceivers. (J and P). Judgers need to make decisions, have closure. Judgers have well maintained diaries and don’t forget meetings. Perceivers are always looking for more and more opportunities and sometimes forget to make the decisions. Sometimes they forget important engagements but they are also able to be spontaneous and take on last minute tasks without getting flustered.
Sorry about that slightly long introduction to Myers Briggs. In a moment it will become apparent why I have taken the time to outline the underlining principles of the theory.
But first I want to tell you a little bit about me.
I have been ‘out’ as someone who has been labelled as having a mental illness for a decade now. Something in the way I ‘do the world’ has propelled me towards a position where I have knuckled down to a life ‘on the frontline’. Sometimes I know it is about the way I have been treated by the system and my wish is to turn horrible experiences into positive energy for change. Whatever it is I find that ten years down the track I am still here talking to people, exchanging stories and working towards a principle goal of making things better for people who experience mental illness or emotional distress.
For most of the ten years I have been working in Victoria. One of the most important projects I have been involved with is the Understanding and Involvement (U&I) Project. During this time I was employed by the Victorian Mental Illness Awareness Council (VMIAC) which is the peak organisation for consumers in Victoria. Whilst I was employed by VMIAC the organisation undertook some professional development. All of us who worked for VM (that’s what we affectionately called it for short) got involved. This was about consumers. It was also about people who didn’t identify as consumers but who were passionate about social justices and about changing systems and systemic relationships with consumers. It was about people (consumers and non-consumers) who were paid for their work (including me) and people (consumers and non-consumers) who were working voluntarily to support the organisation and change the mental health system.
The reason why I mention this particular activity was because it was to be my introduction to the tools of Myers-Briggs. It is also true that I was somewhat stunned by what we learnt that day. In doing Myers Briggs each participating person ends up with a set of four letters which describes their preference in terms of their relationship with work. People might be I.N.T.J or E.S. F.J or I.N.T.P. (Yes, gobledygook to the uninitiated). Much work has been done to develop an idea of what percentage of people in the community fit into each of the possible four letter combinations. There is also an understanding that certain ‘types’ fit better into certain environments.
I am an INFP. This means that I get my inspiration from going inside myself for strength. I am intuitive. I am hopeless with detail and sometimes very inaccurate but I am good at developing theory. I am driven by my core values to the point of pain. Doing things because they seem the most convenient or logical is foreign to my way of being. Finally I am a perceiver. I give priority to relationships and sometimes don’t get things completed by the deadline. I can give a talk to 500 people at short notice but I have been known to forget that I have invited people home for dinner.
The thing that really stuck in my mind was that person after person after person working for a consumer organisation were reporting back that they were NFs – intuitive feelers. It was amazing, how this made me feel. I couldn’t believe that I was surrounded by so many people who felt like me, were driven like me, could relate to the same stories of working practice that I was able to relate to. This was so different from my experience in several other workplace situations.
What was it, we asked, about consumers and those drawn to consumer politics that meant that so many of us dealt with the world through our intuition and feelings? Why, we asked, was this category INFP over represented in such a comprehensive way? Is there something linking the attributes of the INFP and those who have been labelled as mentally ill? (and I say this in a truly proud and respectful way to the other INFP’s in the world!) Is there a way of doing the world of work that is ‘successful’ in terms of ‘staying employed’, ‘getting promoted’, ‘coping with stress’, ‘earning a lot of money’ that is indeed in some ways the antithesis of the ways some of us who have been labelled mentally ill prioritise our life’s work. Has the Myers-Briggs got something to teach us about those who like me ‘do things’ in ways that appear inefficient, clumsy, too-emotional, too-sentimental, too-personalised, too theoretical, anti-authoritarian, inaccuate, untidy, expansive, disorganised etc.
I don’t want to say anything profound about the relationship between Myers-Briggs Type and mental illness. Wobetide that I should be so presumptive! I am a storyteller. I just want to tell the story. I have a friend who has found it useful for himself to talk about ‘going INFP’ when he starts to relate to the world in ways that our society does not endorse through common sanctions and rewards. Those of us who were involved with that day of training and who still work in and around mental health politics often find moments to laugh about our NF-ness and the way we are continually being ‘misunderstood’ or ‘unappreciated’.
However it is not just a joke! There are real issues about the relationship between mental illness, the world of work, economic rationalism, globalisation and politics. It is not OK to just take an idea of mental health and work and talk only in health promotion terms about resilience without questioning the underlying assumptions and assumed relationship between ‘work’ and ‘efficiency’, ‘work’ and ‘authority’, ‘work’ and questionable assumptions about ‘professionalism’ etc. There is also something else to be learned about how we (the less resilient perhaps) relate to the working world. What messages have we got for the rest of society.
It is now time to introduce a friend of mine. This is my dead canary. He travels with me from time to time and likes going to conferences. At one conference he insisted on displaying himself on my hat. I want to introduce you to the dead canary because this is the message I would like you to take home with you about the relationship between ‘mental illness’ and work.
Sometimes I think of us, consumers, people who have been labelled as having mental illness, as society’s canaries. I expect you all remember the stories of what happened in the mines in the 19th century. The little canary was taken down the mines in a cage. If the air was putrid (the system stunk) the little bird would die and this would be a warning sign for the miners to get out. I would like to leave today with a message about people who have been labelled mentally ill. Sometimes we too take on the attributes of the canary. In workplaces we are likely to feel bad air perhaps before anyone else has even noticed that the windows are shut. We are likely to ‘get sick’ and sometimes this can be on behalf of so-called normal people. I like to describe us in a positive way by indicating that we are the exquisitely sensitive ones. If you listen to us you may learn something about the corporate air- about the emotional health of the organisation. People with exquisite sensitivity have something to offer. Society at work might just learn something from us and we might, at last, start to be seen as an asset in the workplace culture- an important litmus test of occupational sanity.